Provider Demographics
NPI:1760344691
Name:FORD, JOSLYNN
Entity type:Individual
Prefix:
First Name:JOSLYNN
Middle Name:
Last Name:FORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 E 35TH AVE APT 2G
Mailing Address - Street 2:
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-1406
Mailing Address - Country:US
Mailing Address - Phone:773-971-7660
Mailing Address - Fax:
Practice Address - Street 1:1121 E 35TH AVE APT 2G
Practice Address - Street 2:
Practice Address - City:GRIFFITH
Practice Address - State:IN
Practice Address - Zip Code:46319-1406
Practice Address - Country:US
Practice Address - Phone:773-971-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-01
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN343900000X, 251E00000X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health
No343800000XTransportation ServicesSecured Medical Transport (VAN)